title: High-throughput screening of colonization samples for methicillin-resistant Staphylococcus aureus.
abstract: BACKGROUND
  We present here the first application of 2-photon excited fluorescence detection (TPX) technology for the direct screening of clinical colonization samples for methicillin-resistant Staphylococcus aureus (MRSA).
  
  
  METHODS
  A total of 125 samples from 14 patients with previously identified MRSA carriage and 16 controls from low-prevalence settings were examined.
  
  
  RESULTS
  The results were compared to those obtained by both standard phenotypic and molecular methods. In identifying MRSA carriers, i.e. persons with at least 1 MRSA positive colonization sample by standard methods, the sensitivity of the TPX technique was 100%, the specificity 78%, the positive predictive value 75%, and the negative predictive value 100%. The TPX assay sensitivity per colonization sample was 89%, the specificity 93%, the positive predictive value 84%, and the negative predictive value 95%. The median time for a true-positive test result was 3 h and 26 min; negative test results are available after 13 h. The assay capacity was 48 samples per test run.
  
  
  CONCLUSIONS
  The TPX MRSA technique could provide early preliminary results for clinicians, while simultaneously functioning as a selective enrichment step for further conventional testing. Costs and workload associated with hospital infection control can be reduced using this high-throughput, point-of-care compatible methodology.
authors.affiliation: From the Department of Medicine, Turku University Hospital and University of Turku.
authors.forename: Teppo
authors.initials: T
authors.lastname: Stenholm
authors.forename: Antti J
authors.initials: AJ
authors.lastname: Hakanen
authors.forename: Emmi
authors.initials: E
authors.lastname: Hakanen
authors.forename: Harri
authors.initials: H
authors.lastname: Härmä
authors.forename: Monica
authors.initials: M
authors.lastname: Österblad
authors.forename: Jaana
authors.initials: J
authors.lastname: Vuopio
authors.forename: Pekka E
authors.initials: PE
authors.lastname: Hänninen
authors.forename: Pentti
authors.initials: P
authors.lastname: Huovinen
authors.forename: Kaisu
authors.initials: K
authors.lastname: Rankakokko-Jalava
authors.forename: Pirkko
authors.initials: P
authors.lastname: Kotilainen
mesh_terms: D002353:Carrier State / Q000175:diagnosis / Q000382:microbiology*; D005455:Fluorescent Antibody Technique / Q000379:methods; D006119:Groin / Q000382:microbiology; D057166:High-Throughput Screening Assays / Q000379:methods*; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D009296:Nasal Cavity / Q000382:microbiology; D010502:Perineum / Q000382:microbiology; D012680:Sensitivity and Specificity; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000382:microbiology*